POS1318 JUVENILE IDIOPATHIC ARTHRITIS DISEASE ACTIVITY IN TRANSITIONAL CARE
Authors: K. Carpio, C. Burgeois Avella, J. C. Lopez Robledillo, D. Clemente, L. Trives Folguera, F. Montero, I. Monteagudo, J. M. Alvaro-Gracia, J. C. Nieto González
Journal: Annals of the Rheumatic Diseases (2022)

Background Juvenile Idiopathic Arthritis (JIA) is a group of heterogeneous arthritis with onset earlier than 16 years old. According to previous studies, these patients experience an improvement of their disease activity, functionality and even remission probability as they become young adults. [1] Transitional care units aim to coordinate an uninterrupted follow-up in patients with chronic diseases in order to accomplished the objective of improving the ability of manage their own disease. [2] Our transitional care unit attend patients from 18 to 25 years old who have been previously diagnosed with any pediatric rheumatic disease Objectives Our primary objective was to describe the disease activity of JIA patients at the transference to our unit and the remission maintenance during follow-up. Methods We conducted an observational retrospective longitudinal study from a cohort of patients with JIA who have been transferred to our transitional care unit. We selected patients with at least one clinical visit and active follow-up. We collected demographic data, JIA classification, previous treatments and the treatment at time of transfer, articular and ocular flares, remission defined by Wallace criteria 3 and changes in treatment during follow-up. We calculated the percentage of patients who had active disease activity at the transference to the Unit and the proportion of patients who had an inflammatory flare (ocular or articular) during the follow-up. Results From December 2016 to December 2021 we received 184 patients in our Transitional Care Unit, from them 127 had a JIA and 1 had asymptomatic chronic uveitis. Demographics of JIA patients is shown in Table 1. From 127 JIA patients, 34 (26,8%) were active at the transference and 53 (41,8%) had at least one flare during the follow-up. Table 1. Demographic data from JIA included in the study, divided according to disease activity at the transference to our transitional care unit. Total (n: 127 ) Actives (n:34 ) Not actives (n:93 ) Sex (female) n (%) 84 (66.1) 24 (70.6) 60 (64.5) Age median (IR) 8.64 (3-13) 9.1 (3-13) 8.4 (3-12.9) Previous joint injections n(%) 43 (33.9) 16 (47.1) 27 (29) sDMARD prior transference n (%) 98 (76.6) 26 (76.5) 72 (77.4) bDMARD prior transference n (%) 79 (61.7) 20 (58.8) 59 (63.4) Uveitis n (%) 23 (18.1) 8 (23.5) 15 (16.1) JIA subcategory n (%) oligo persist 43 (33.9) 12 (35.3) 31 (33.3) oligo extend 16 (12.6) 3 (8.8) 13 (14) poly RF - 25 (19.7) 6 (17.6) 19 (20.4) poly RF + 3 (2.4) 1 (2.9) 2 (2.2) ERA 24 (18.9) 8 (23.5) 16 (17.2) systemic 9 (7.1) 2 (5.9) 7 (7.5) psoriatic 7 (5.5) 2 (5.9) 5 (5.4) We calculated the percentage of patients who had active disease at the transference to the Unit and the percentage of patients who had an inflammatory flare during the follow-up. Figures 1 and 2 showed the proportion of flares depending on the inflammatory status at transference to the Transitional care unit and the use of biological therapy before transition. Conclusion JIA patients remain active in one quarter of the cases at the transference to the Transitional care unit and flares are twice frequent when they were active at the transference. References [1]S. Sabbagh, T. Ronis, PH White. Pediatric rheumatology: addressing the transition to adult-orientated health care. Research and Reviews 2018:10 83–95 [2]H. Relas, R. Luosujärvi, S. Kosola. Outcome of transition phase patients with juvenile idiopathic arthritis, Modern Rheumatology 2018 Sep;28(5):32-837 [3]Wallace CA, Ruperto N, Giannini EH, Childhood Arthritis and Rheumatology Research Alliance, Pediatric Rheumatology International Trials Organization, Pediatric Rheumatology Collaborative Study Group. Preliminary criteria for clinical remission for select categories of juvenile idiopathic arthritis. J Rheumatol2004; 31 :2290–4 Disclosure of Interests None declared